Monthly Archives: July 2017

This is the fourth post in a four-part series on the American healthcare system.

Pre-Existing Conditions

The Individual Mandate required all Americans not covered by a “qualifying plan” to purchase insurance or pay a penalty. We require basic car insurance to legally drive, so why not health insurance? However, this is an apples-to-oranges comparison. Driving is a privilege and is voluntary (we can choose not to drive), while one’s health is impossible to separate from the individual. Compelling citizens to buy something from the government, just because they are alive, borders on the tyrannical. Besides, the government’s interests are often not aligned with our own.

The Costs of “Billing Through Insurance”

Earlier this year one of my patients went to the ER with abdominal pain. The provider ordered a CT of the abdomen and pelvis with contrast because they thought he might have a kidney stone. They gave him some IV fluids and medications, and admitted him to the hospital for a few hours before discharging him home. They billed his insurance $18,000, but only $12,000 of this was covered. He now owes $6,000 for his brief stay.

Another one of my patients went to the ER just this last month for some stitches after being hit in the mouth with a baseball. After the charges were billed through his insurance, he was informed his plan was “out of network” and he now owes them $3,600.

Medicaid, and Why Single Payer Won’t Work

The Obamacare rollout was fraught with missteps and confusion, and this wasn’t just limited to the healthcare.gov web site. Not only did most Americans’ healthcare costs not go down, President Obama’s repeated statement “If you like your healthcare plan, you can keep it” was given Politifact’s Lie of the Year award in 2013.

“It is amazing that people who think we cannot afford to pay for doctors, hospitals, and medication, somehow think that we can afford to pay for doctors, hospitals, medication, and a government bureaucracy to administer it.” – Thomas Sowell

Introduction

Our healthcare system is in crisis. While there seems to be agreement among most Americans and policy makers on this point, the debate about what the primary causes are and how to salvage it is ongoing.